Objective To investigate maternal risk factors for fetal congenital heart diseases (CHD). Methods A case-control study was conducted on 16 645 pregnant women who underwent cardiovascular malformation screening for fetal cardiovascular system,whose pregnancy outcomes were recorded,and whose newborns were scanned by an echocardiography in Peking University People's Hospital,Haidian,Changping,Mentougou and Daxing Maternal and Child Health Hospital from Nov.2006 to Oct.2009.One hundred and twelve pregnant women whose babies were found to be CHD (40 severe CHD and 72 simple CHD) before or after delivery were taken as study group.Women in control group (n =304) were randomly selected from those pregnant women who had infants without CHD.Logistic regression analysis and x2 test were used to analyze the maternal risk factors for fetal CHD. Results (1) The average age of women whose infants had severe CHD was 28.3 years (21-40 years),and it was 29.9 years (22-39 years) for women whose infants had simple CHD.There were no significant differences between the control group (29.5 years,20-44 years) and the above two groups (t=1.511 and -0.826,P=0.138 and 0.410 respectively).(2) Single factor analysis:during first trimester,the rate of upper respiratory infection (18/39,46.2 ％) and exposure to certain chemicals (13/40,32.5％) of severe CHD group were higher than those of control group [(14.9％ (45/303) and 2.0％ (6/304)] (x2 =22.399 and 62.678,OR=4.895 and 23.753,95％CI:2.419-9.905 and 8.358-67.506,P =0.000 respectively).Compared with control group (0.0％,0/304),the rate of pregnant women with CHD family history in simple CHD group was significantly higher (4.2％,3/72)(Fisher exact test,P=0.007).(3) Logistic regression analysis:maternal upper respiratory infections (OR =5.120,95％CI:2.340-11.206,P =0.000) and exposure to certain chemicals (f)R=23.030,95％CI:7.506-70.665,P=0.000) during first trimester were risk factors for fetal severe CHD. Conclusions Upper respiratory infection and exposure to certain chemicals during first trimester might play important roles in the occurrence of fetal severe CHD.Maternal family history of CHD might associate with fetal simple CHD.

Objective The clinical manifestations of cerebral infarction caused by acute basilar arterial occlusion are complex.The purpose of this study is to explore the relationship between lesion location and onset symptoms of cerebral infarction caused by acute basilar arterial occlusion.Methods Fifty three patients diagnosed with cerebral infarction caused by acute artery occlusion were collected from Nanjing Stroke Registry.They were hospitalized in Jinling Hospital from January 2007 to July 2016 and were divided into sudden onset group and progressive onset group.Their clinical and digital subtraction angiography data were analyzed retrospectively.Results Middle and distal segment of the basilar artery occlusions were usually found in sudden onset group.Patients in progressive onset group were more likely to present with proximal segment of the basilar artery occlusions.Significant statistical difference was found between two groups (P<0.05).Logistic regression analysis showed that the symptoms of patients with proximal segment basilar artery occlusion tended to be progressive onset, compared with patients affected by distal segment occlusion (OR=14.77,95%CI:1.57-139.00, P=0.019).Conclusion There was significant relationship between lesion location and onset symptoms of cerebral infarction caused by acute basilar arterial occlusion.Early diagnosis and timely treatment may improve clinical prognosis in patients.

Stroke has a high incidence and disability rate, and rehabilitation is an effective means to reduce the disability rate of patients. To systematize rehabilitation assessment, which is the foundation for rehabilitation therapy, we summarize the assessment methods commonly used in research and clinical applications, including the various types of stroke rehabilitation scales and their applicability, and related biomedical detection technologies, including surface electromyography (sEMG), motion analysis systems, transcranial magnetic stimulation (TMS), magnetic resonance imaging (MRI), and combinations of different techniques. We also introduce some assessment techniques that are still in the experimental phase, such as the prospective application of artificial intelligence (AI) with optical correlation tomography (OCT) in stroke rehabilitation. This review provides a useful bibliography for the assessment of not only the severity of stroke injury, but also the therapeutic effects of stroke rehabilitation, and establishes a solid base for the future development of stroke rehabilitation skills.
Artificial Intelligence ; Humans ; Magnetic Resonance Imaging ; Stroke ; Stroke Rehabilitation/methods* ; Transcranial Magnetic Stimulation/methods*

Objective To observe the application effect of magnetic resonance imaging technology in evaluating the brain structure and function of patients with type 2 diabetic painful neuropathy (PDN). Methods Forty patients with type 2 diabetes mellitus hospitalized in our hospital were selected as the study objects, and were divided into diabetes mellitus (DM) group (n=12), peripheral neuropathy (DPN) group (n=14) and PDN group (n=14). General clinical biochemical indexes of three groups were analyzed. The structural brain and function of brain area in three groups were compared. Results Age, duration of diabetes, systolic blood pressure, diastolic blood pressure, fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), free fatty acid (FFA), albumin (ALB), creatinine (Cr), uric acid (UA), estimated glomerular filtration rate (eGFR), cystatin C (Cys-C), total cholesterol (TC), triglyceride (TG) of the three groups were compared, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPO-Ab) and serum calcium (Ca) in the three groups showed no significant differences (P > 0.05). Compared with the DM group, the gray matter volume (GMV) in the DPN group was significantly decreased (P < 0.05). Compared with the DM group, amplitude of low frequency fluctuation (ALFF) and fractional amplitude of low frequency fluctuation (fALFF) of left medial superiorfrontal gyrus in the PDN group were significantly decreased (P < 0.05). Conclusion Abnormal GMV in the left angular gyrus in DPN patients may be associated with a higher risk of concomitant cognitive impairment. The decrease of ALFF in the right cerebellar vermis and fALFF in the left medial superior frontal gyrus in PDN patients may be related to the pathogenesis of pain.

OBJECTIVETo observe whether bladder controller can restore bladder function in paraplegic dogs.

METHODSFour dogs were studied after their T(10) spinal cord was transected. Electrodes implanted around S(2) bilaterally were connected to subcutaneous recievers. Microsurgical techniques were employed in dorsal rhizotomy at S(1 - 3) intradural segment. After daily stimulation, the results of bladder controller were evaluated by micturition and vesicography.

RESULTSMicturition was given under electrical stimulation with a urine volume of 80 - 140 ml per time. The mode of micturition was post-stimulus voiding. Vesicography showed that the bladder was filled and bladder neck was open in the micturition course of electric stimulation. Residual urine volume was 15 - 20 ml.

CONCLUSIONBladder controller together with a sacral deafferentation procedure can restore bladder function of paraplegic dogs.

Animals ; Disease Models, Animal ; Dogs ; Electric Stimulation ; Male ; Spinal Cord Injuries ; physiopathology ; surgery ; Urinary Bladder ; physiopathology ; surgery ; Urination

Objective To investigate the clinical pathologic features of a distinct variant of focal cortical dysplasia (FCD) characterized by neuronal loss of layer four.Methods Between 2005 and 2017,approximately 3 000 surgeries were performed for the treatment of intractable epilepsy at Xuanwu Hospital,Capital Medical University and Yuquan Hospital,Tsinghua University.Retrospective analysis of clinic-pathological data of patients with epilepsy surgery was made and histological manifestations of neuronal loss of cortical layer four were included in this study.Results In this cohort,25 patients (22 males and three females) were identified with early onset pharmaco-resistant epilepsy and regionally circumscribed neuronal loss of cortical layer four in surgical specimens from the occipital lobe.Histologically,except for neuronal loss in cortical layer four in all cases,glial scar lesions were found in some patients.Thus the histology of those cases can be subdivided into two groups:group A (13 cases):neuronal loss of cortical layer four without glial scar lesions;and group B (12 cases):neuronal loss of cortical layer four with glial scar lesions.Due to the prominent horizontal disorganization of cortical layering and lack of any other microscopically visible principle lesion,group A should be classified hitherto as FCD International League Against Epilepsy (ILAE) type Ⅰ b,however,group B with scar lesions and cortical dysplasia around the main leision,should be classified as FCD ILAE type Ⅲd.This retrospective analysis of clinical histories revealed a perinatal distress in 20 patients (80％),suggesting an acquired pathomechanism.Magnetic resonance imaging revealed abnormal signals in the occipital lobe in all patients,and signal changes suggestive of encephalomalacia were found in 18 patients.Surgical treatment achieved favorable seizure control (Engel class Ⅰ and Ⅱ) in 18 patients (75％ among 24 available follow up).Comparion of the two groups with age at epilepsy onset (group A:5.00±2.76,group B:5.01±3.78),the proportion of perinatal distress (group A:11/13,group B:9/12) and the follow-up results (favorable seizure control of the two groups was 9/13,9/11 respectively) showed that there was no statistically significant difference between the two groups.Conculsion Neuronal loss of cortical layer four in the occipital lobe should be classified as a distinct variant of FCD ILAE type Ⅲd.

Objective:To understand the survival status and related influencing factors of HIV-infected children aged ≤14 years old, in China.Methods:HIV-infected children were selected from the China’s HIV/AIDS Comprehensive Response Information Management System (CRIMS). A retrospective cohort study was conducted to investigate the situation of survival on infected children. Cox proportional hazard regression model was used to screen the factors affecting the survival time.Results:This study involved 8 029 cases of infected children, with a median survival time of 179.75 months. The cumulative survival probabilities at 1 year, 2 years, 5 years, and 10 years after the diagnosis, were 99.13 %, 97.95 %, 90.11 % and 78.63 %, respectively. Results from the multivariate Cox proportional hazard regression analysis showed that children who did not receive antiviral therapy were 12.81 times more likely to die than the ones who received the antiretroviral therapy (95 %CI: 11.40-14.27). Male HIV-infected children were 1.20 (95 %CI: 1.10-1.32) times more likely to die than the female HIV-infected children. The risk of death among HIV positive children at the age of 3 to 5 years was 0.67 (95 %CI: 0.60-0.76) times of those children who were diagnosed at the age of 2 years old or younger. The risk of death among children infected with HIV in Northwest was 0.52 (95 %CI: 0.29-0.95) times higher than the ones from the Northeast areas of China. The risk of death among children who received antiviral treatment (ART) in the residential areas was 1.96 (95 %CI: 1.48-2.61) times than those children who did not. The risk of death from children who did not receive health care services was 2.07 times of those children who did (95 %CI: 1.88-2.29). Conclusions:The median survival time of HIV-infected children aged ≤14 years old was 179.75 months, in China. Our findings revealed that initiation of antiviral therapy, female, age, place of receiving ART (out of the residential areas), living in Northwest China, care services and being diagnosed at older age etc. were protective factors influencing the survival time of infected children.

To investigate the presence of integrated Epstein-Barr virus (EBV) DNA in the NK/T cell lymphoma (NKTCL) ge-nome and analyze the integration information in the genome of NKTCL cell lines. Methods: PCR and in situ hybridization were used to detect EBV infection in five EBV (+) NK/T samples and four EBV (-) NK/T samples provided by the biobanks of the First Affiliated Hospi-tal of Zhengzhou University. Whole-genome DNA of the samples was sequenced and subjected to bioinformatics analysis. Whole-ge-nome sequence alignment was used to identify the EBV integration sequence. BLAST analysis was used to compare EBV fasta files of the samples and EBV fasta library. CREST software was used to extract softclip reads, filter all paired reads, and enumerate their distri-bution on chromosomes. The integrated genomics viewer (IGV) was used to compare the distribution of reads in partial regions of chromosome. PCR was used to amplify the high-frequency integration region of the EBV DNA. The amplified fragments were sanger se-quenced. Results: EBV DNA and EBER expression were detected in five EBV (+) NK/T samples but not in the four EBV (-) NK/T samples. Sequencing depth, coverage depth, proportion of coverage, and proportion of alignment all met the requirements for subsequent re-search. Sequence alignment revealed that the captured sequences were viral sequences. Filtered reads were most numerous in EBV (+) NKTCL cell line SNK, YTS, and EBV (+) nasal NKTCL tissue. The reads were non-randomly enriched in chromosome 2. EBV DNA inte-gration in the 400 bp region of chr2:30234084-30234483 caused insertion or deletion in the chr2p23.1 site. Conclusions: EBV DNA is highly integrated in the chr2p23.1 site of EBV (+) NKTCL cells and may affect the expression of related genes.

The hospital introduced a multi-department synergy in management of the rational use of carbapenems. Specifically,the medical affairs department conducts training and appraisal of doctors along with a monthly checkup of medical records. The pharmaceutical affairs division conducts prior prescriptions checkup and follow-up comment. The clinical microbiology laboratory and the hospital-acquired infection management department monitors and releases such infection and bacterial resistance information of the whole hospital in real time. The results showed increased prescriptions of imipenem and cilastatin sodium, and decreased prescriptions of biapenem for injection. Drug resistance analysis showed that carbapenem resistant strains increased by 28%,but the total number of patients reduced by 10% and total number of patients with multidrug resistance remained unchanged. It is proposed to further antimicrobial stewardship in the hospital to achieve rational drug use and curb bacterial resistance.